Gradually Approaching a Plan

We’re (probably) going to decide the next eight months depending on what the doctor tells us today about the next course of action and how long it will take, assuming she doesn’t simply send us for more tests (and/or wait for the results of the one that’s in six days).

This feeling — it is not unlike waiting for university acceptance/rejection letters.

After the Appointment

The results point to IVF as our only high-probability-of-success choice. However, as IVF is expensive, involved, and invasive, most clinics perform approximately four cycles of Intrauterine Insemination (IUI) first. This option is much cheaper, not very invasive, and quick and easy to start each cycle or even skip for a cycle.

We’re not good candidates for IUI but it does fit perfectly with our scenario of moving across the country four months after this consultation. And, crossing it off the list of possible procedures is helpful should our new clinic in Ontario deem it a necessary step on our way towards IVF.

Because of our low chance of success, only two cycles are indicated for us. We have four available cycles before we wanted to move, two of which are likely to be too busy with my work placement and travel to allow me to make the appointment. The other two are now earmarked as our first intervention.

I was actually thinking I wouldn’t be able to stomach IVF but it’s wooing me with its high probability of success for our circumstances.

As a young woman, not only do I have a high chance of getting pregnant if they can make some embryos, I can also freeze a handful and we might not have to go through that part of the process anymore; we just call up when we’re ready for the next kid. However, that’s dependent on them getting that handful. But wow, does that make me excited; it would be an actual, real upside to all of this — we’d have embryos from when I was 28 or 29 on ice and we could have babies much later than I would be comfortable with otherwise.

But yes, there was still more testing to continue to confirm that no other confounding factors.

I’d never heard of a hysterosalpingogram (HSG) before. Luckily, I talked to my support group about them before my appointment which made me wise to the fact that it was not going to be “like a PAP smear” as my specialist advertised it. Unluckily, it took several months for me to get in for one because of the circumstances surrounding them.

An HSG must be scheduled in a very small window at the beginning of each cycle, and only a few appointments are available each month at only a handful of testing facilities even in a large city like the Greater Vancouver Region.

Because of those restrictions, I couldn’t lend much weight to the warnings from support group about the better and worse locations for the test. Apparently, the central location had equipment “from the Cold War era”, but I figured that I wouldn’t let the psychological effect of outdated-looking equipment delay me yet another month. I took the first appointment available from the first clinic to open when my cycle-start cooperated with business hours, and unfortunately, it was at the “older” facility.

Then I learned the physiological effect of outdated equipment. Suffices to say that the procedure was much more physically distressful and therefore emotionally stressful for its very medieval-seeming equipment, and that I highly recommend shopping around for newer equipment, or, failing that option, bracing yourself for a Very Difficult Time so that you aren’t blindsighted. That might sound like fearmongering, but it was the kind of stress I wish I’d steeled myself for instead of learning about while hooked up to the equipment. Ask me about it before you find yourself there.

The other test I needed was a scan via transvaginal ultrasound. This, in contrast to the HSG, proved to be surprisingly easy.

Transvaginal ultrasounds have earned a bad reputation lately. Certainly, the procedure would be horrendous when forced upon someone. But I had been whipped up into a terrified mess about it when, for a consenting patient eager for all the diagnostic information possible, it was a quick and painless scan.

Well, painless in the sense of no physical pain and very little discomfort. Emotionally, however, was another story.

The ultrasound machine is the same when used for an ultrasound for any reason. Kidneys, arteries, ovaries, or pregnancy — I’m under the impression it’s the same machine. Different wands might be used, but the image always has that fifth-of-a-circle shape:

That’s an image I have stolen from some random site thanks to Google Images because I didn’t have a camera at the time, but the empty part-circle image was the same on the machine that was already up and running when the nurse showed me in.

A tonne of bricks landed on me when I saw that screen. This wasn’t how I had imagined the first time looking at one of these.

Later, the doctor would ask me if I wanted to see what she was looking at. “No,” I told her, “I don’t think I could handle the emptiness. By the way, when are YOU due?” since, of course, my specialist was pregnant. After she left, I couldn’t help but look at the collection of screen shots, like morbidly staring at a train wreck.

Also worth mentioning: I was super-lucky to have friends to drive me to each appointment. My mother-in-law was visiting coincidentally during my HSG and a girlfriend came to stay so I wouldn’t be alone when my husband had to travel the day of my ultrasound. Later, my husband and I would have to sign consent forms and realized we had no one near enough to us to witness them, and had to use the clinic’s receptionist. These experiences in needing backup solidified for me how we absolutely had to move home before becoming parents.

End of Month 20

At the end of month 20, we are finished all the testing the clinic needs to confirm its earlier determination of two IUI cycles with next-to-no chance of success, followed by IVF once we are settled back home in Ontario.